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2024 PERM Review – Medical Record Requests

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Texas is currently undergoing the Centers for Medicare & Medicaid Service (CMS) Payment Error Rate Measurement (PERM) review. The review includes Texas Medicaid and CHIP claims paid from July 1, 2022, though June 30, 2023. CMS has contracted with Empower AI to review providers sampled for medical record compliance. Providers must participate in the PERM review and provide the requested medical record documentation that supports the sampled claim.

Methods of Provider Notification

Sampled LTC providers will receive a series of communications:

  • An Empower AI representative will call the provider’s point of contact to confirm mailing address and fax number prior to mailing and faxing the medical record request letter.
  • An Empower AI representative will reach out if submitted records are not complete, requesting the missing documentation be submitted.

Important: If a provider fails to respond to CMS or submit complete and correct documentation for a sampled LTC provider claim within the time frame indicated in the notice, Empower AI will identify the claim as a PERM exception. In the event of a PERM exception, the total amount paid for the claim must be reimbursed per state and federal requirements.

Providers with questions about the records request should immediately contact Empower AI customer service representatives at 800-393-3068.